Clinical outcome of catheter ablation in patients with nonparoxysmal atrial fibrillation results of 3-year follow-up

Tze Fan Chao; Hsuan Ming Tsao; Yenn Jiang Lin; Chin Feng Tsai; Wei Shiang Lin; Shih Lin Chang; Li Wei Lo; Yu Feng Hu; Ta Chuan Tuan; Kazuyoshi Suenari; Cheng Hung Li; Beny Hartono; Hung Yu Chang; Kibos Ambrose; Tsu Juey Wu; Shih Ann Chen

doi:10.1161/CIRCEP.111.968032

Clinical outcome of catheter ablation in patients with nonparoxysmal atrial fibrillation results of 3-year follow-up

Tze Fan Chao, Hsuan Ming Tsao, Yenn Jiang Lin, Chin Feng Tsai, Wei Shiang Lin, Shih Lin Chang, Li Wei Lo, Yu Feng Hu, Ta Chuan Tuan, Kazuyoshi Suenari, Cheng Hung Li, Beny Hartono, Hung Yu Chang, Kibos Ambrose, Tsu Juey Wu, Shih Ann Chen^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

109 Scopus citations

Abstract

Background-Catheter ablation of atrial fibrillation (AF) became an effective therapy for patients with drug-refractory AF, and the indications have broadened to include nonparoxysmal AF patients. However, data about the long-term effectiveness of ablation in patients with nonparoxysmal AF are lacking. The aim of the present study was to investigate the long-term outcomes of catheter ablation in patients with nonparoxysmal AF. Methods and Results-A total of 88 nonparoxysmal AF patients who received a stepwise catheter ablation (isolation of the pulmonary veins plus substrate modification) from 2006 to 2008 were enrolled. Freedom of recurrence was defined as the absence of atrial arrhythmias without using any antiarrhythmic agents after the catheter ablation. There were 63 patients (71.6%) with recurrences (47 patients with AF and 16 patients with atrial flutter/atrial tachycardia) after the initial procedure during a median follow-up period of 36.8 months. A CHADS2 score of =3 and the left atrial (LA) diameter were significant predictors of recurrences in the multivariable analysis. Of the patients with CHADS₂ scores of ≥=3 and an LA dimension ≥=44 mm, all had recurrences within 1 year after the initial procedure. The overall recurrence-free rate could increase to 47.7% after the second procedure and 51.1% after the third procedure. Conclusions-The long-term recurrence-free rate of ablation in nonparoxysmal AF was only 28.4% after a single procedure, and multiple procedures were necessary to raise the recurrence-free rate. The CHADS₂ score and LA dimension may help us to identify patients who will have recurrences after catheter ablations of nonparoxysmal AF.

Original language	English
Pages (from-to)	514-520
Number of pages	7
Journal	Circulation: Arrhythmia and Electrophysiology
Volume	5
Issue number	3
DOIs	https://doi.org/10.1161/CIRCEP.111.968032
State	Published - Jun 2012

Keywords

Catheter ablation
Long-term outcome
Nonparoxysmal atrial fibrillation
Recurrence

Access to Document

10.1161/CIRCEP.111.968032

Cite this

Chao, T. F., Tsao, H. M., Lin, Y. J., Tsai, C. F., Lin, W. S., Chang, S. L., Lo, L. W., Hu, Y. F., Tuan, T. C., Suenari, K., Li, C. H., Hartono, B., Chang, H. Y., Ambrose, K., Wu, T. J., & Chen, S. A. (2012). Clinical outcome of catheter ablation in patients with nonparoxysmal atrial fibrillation results of 3-year follow-up. Circulation: Arrhythmia and Electrophysiology, 5(3), 514-520. https://doi.org/10.1161/CIRCEP.111.968032

@article{dcfd75412f7148e0845e8d3a49cd672c,

title = "Clinical outcome of catheter ablation in patients with nonparoxysmal atrial fibrillation results of 3-year follow-up",

abstract = "Background-Catheter ablation of atrial fibrillation (AF) became an effective therapy for patients with drug-refractory AF, and the indications have broadened to include nonparoxysmal AF patients. However, data about the long-term effectiveness of ablation in patients with nonparoxysmal AF are lacking. The aim of the present study was to investigate the long-term outcomes of catheter ablation in patients with nonparoxysmal AF. Methods and Results-A total of 88 nonparoxysmal AF patients who received a stepwise catheter ablation (isolation of the pulmonary veins plus substrate modification) from 2006 to 2008 were enrolled. Freedom of recurrence was defined as the absence of atrial arrhythmias without using any antiarrhythmic agents after the catheter ablation. There were 63 patients (71.6%) with recurrences (47 patients with AF and 16 patients with atrial flutter/atrial tachycardia) after the initial procedure during a median follow-up period of 36.8 months. A CHADS2 score of =3 and the left atrial (LA) diameter were significant predictors of recurrences in the multivariable analysis. Of the patients with CHADS2 scores of ≥=3 and an LA dimension ≥=44 mm, all had recurrences within 1 year after the initial procedure. The overall recurrence-free rate could increase to 47.7% after the second procedure and 51.1% after the third procedure. Conclusions-The long-term recurrence-free rate of ablation in nonparoxysmal AF was only 28.4% after a single procedure, and multiple procedures were necessary to raise the recurrence-free rate. The CHADS2 score and LA dimension may help us to identify patients who will have recurrences after catheter ablations of nonparoxysmal AF.",

keywords = "Catheter ablation, Long-term outcome, Nonparoxysmal atrial fibrillation, Recurrence",

author = "Chao, {Tze Fan} and Tsao, {Hsuan Ming} and Lin, {Yenn Jiang} and Tsai, {Chin Feng} and Lin, {Wei Shiang} and Chang, {Shih Lin} and Lo, {Li Wei} and Hu, {Yu Feng} and Tuan, {Ta Chuan} and Kazuyoshi Suenari and Li, {Cheng Hung} and Beny Hartono and Chang, {Hung Yu} and Kibos Ambrose and Wu, {Tsu Juey} and Chen, {Shih Ann}",

year = "2012",

month = jun,

doi = "10.1161/CIRCEP.111.968032",

language = "English",

volume = "5",

pages = "514--520",

journal = "Circulation: Arrhythmia and Electrophysiology",

issn = "1941-3149",

publisher = "Lippincott Williams and Wilkins",

number = "3",

}

Chao, TF, Tsao, HM , Lin, YJ, Tsai, CF, Lin, WS, Chang, SL , Lo, LW , Hu, YF, Tuan, TC, Suenari, K, Li, CH, Hartono, B, Chang, HY, Ambrose, K, Wu, TJ & Chen, SA 2012, 'Clinical outcome of catheter ablation in patients with nonparoxysmal atrial fibrillation results of 3-year follow-up', Circulation: Arrhythmia and Electrophysiology, vol. 5, no. 3, pp. 514-520. https://doi.org/10.1161/CIRCEP.111.968032

TY - JOUR

T1 - Clinical outcome of catheter ablation in patients with nonparoxysmal atrial fibrillation results of 3-year follow-up

AU - Chao, Tze Fan

AU - Tsao, Hsuan Ming

AU - Lin, Yenn Jiang

AU - Tsai, Chin Feng

AU - Lin, Wei Shiang

AU - Chang, Shih Lin

AU - Lo, Li Wei

AU - Hu, Yu Feng

AU - Tuan, Ta Chuan

AU - Suenari, Kazuyoshi

AU - Li, Cheng Hung

AU - Hartono, Beny

AU - Chang, Hung Yu

AU - Ambrose, Kibos

AU - Wu, Tsu Juey

AU - Chen, Shih Ann

PY - 2012/6

Y1 - 2012/6

N2 - Background-Catheter ablation of atrial fibrillation (AF) became an effective therapy for patients with drug-refractory AF, and the indications have broadened to include nonparoxysmal AF patients. However, data about the long-term effectiveness of ablation in patients with nonparoxysmal AF are lacking. The aim of the present study was to investigate the long-term outcomes of catheter ablation in patients with nonparoxysmal AF. Methods and Results-A total of 88 nonparoxysmal AF patients who received a stepwise catheter ablation (isolation of the pulmonary veins plus substrate modification) from 2006 to 2008 were enrolled. Freedom of recurrence was defined as the absence of atrial arrhythmias without using any antiarrhythmic agents after the catheter ablation. There were 63 patients (71.6%) with recurrences (47 patients with AF and 16 patients with atrial flutter/atrial tachycardia) after the initial procedure during a median follow-up period of 36.8 months. A CHADS2 score of =3 and the left atrial (LA) diameter were significant predictors of recurrences in the multivariable analysis. Of the patients with CHADS2 scores of ≥=3 and an LA dimension ≥=44 mm, all had recurrences within 1 year after the initial procedure. The overall recurrence-free rate could increase to 47.7% after the second procedure and 51.1% after the third procedure. Conclusions-The long-term recurrence-free rate of ablation in nonparoxysmal AF was only 28.4% after a single procedure, and multiple procedures were necessary to raise the recurrence-free rate. The CHADS2 score and LA dimension may help us to identify patients who will have recurrences after catheter ablations of nonparoxysmal AF.

AB - Background-Catheter ablation of atrial fibrillation (AF) became an effective therapy for patients with drug-refractory AF, and the indications have broadened to include nonparoxysmal AF patients. However, data about the long-term effectiveness of ablation in patients with nonparoxysmal AF are lacking. The aim of the present study was to investigate the long-term outcomes of catheter ablation in patients with nonparoxysmal AF. Methods and Results-A total of 88 nonparoxysmal AF patients who received a stepwise catheter ablation (isolation of the pulmonary veins plus substrate modification) from 2006 to 2008 were enrolled. Freedom of recurrence was defined as the absence of atrial arrhythmias without using any antiarrhythmic agents after the catheter ablation. There were 63 patients (71.6%) with recurrences (47 patients with AF and 16 patients with atrial flutter/atrial tachycardia) after the initial procedure during a median follow-up period of 36.8 months. A CHADS2 score of =3 and the left atrial (LA) diameter were significant predictors of recurrences in the multivariable analysis. Of the patients with CHADS2 scores of ≥=3 and an LA dimension ≥=44 mm, all had recurrences within 1 year after the initial procedure. The overall recurrence-free rate could increase to 47.7% after the second procedure and 51.1% after the third procedure. Conclusions-The long-term recurrence-free rate of ablation in nonparoxysmal AF was only 28.4% after a single procedure, and multiple procedures were necessary to raise the recurrence-free rate. The CHADS2 score and LA dimension may help us to identify patients who will have recurrences after catheter ablations of nonparoxysmal AF.

KW - Catheter ablation

KW - Long-term outcome

KW - Nonparoxysmal atrial fibrillation

KW - Recurrence

UR - http://www.scopus.com/inward/record.url?scp=84863666798&partnerID=8YFLogxK

U2 - 10.1161/CIRCEP.111.968032

DO - 10.1161/CIRCEP.111.968032

M3 - Article

C2 - 22550126

AN - SCOPUS:84863666798

SN - 1941-3149

VL - 5

SP - 514

EP - 520

JO - Circulation: Arrhythmia and Electrophysiology

JF - Circulation: Arrhythmia and Electrophysiology

IS - 3

ER -

Clinical outcome of catheter ablation in patients with nonparoxysmal atrial fibrillation results of 3-year follow-up

Abstract

Keywords

Access to Document

Other files and links

Fingerprint

Cite this